What are pre-existing health insurance

Before hiring a medical insurance it is essential to take into account not only what characteristics and coverage the health insurance that most interests us presents, but to keep in mind other issues and related elements that, despite being very important, in most of the cases are usually go unnoticed.

This is the case, for example, of those known as lack periods, which consists of a certain period of time during which the insured does not have the right to certain benefits derived from the insurance. In such a way that once this period passes or elapses, the patient can begin to use the insurance with absolute normality. This period usually ranges from 3 months for simple diagnostic tests to 12 months, although it is possible to have access to simple tests and specialist consultations practically from the moment the policy comes into effect.

Another issue to be taken into account is the existence of those known as pre-existing, that the Medical insurance tend to take into consideration when making the purchase of health insurance to the new client.

What are pre-existing health insurance?

As its name indicates, pre-existing conditions are those pathologies or diseases that the person already presents prior to the date of health insurance contracting.

That is, it is any pathology, disease or health condition that the person already knows that suffers and that, for that reason, has already been medically diagnosed prior to contracting the medical insurance.

When is there a pre-existence?

Most medical insurances understand preexisting medical conditions:

  • That the disease or pathology has been diagnosed by a medical specialist.
  • That the disease had already produced expenses.
  • That by its different symptoms or signs, this one could not have gone unnoticed.

We must take into account the last of the points, since we are facing a highly controversial issue. That is, health insurers that deny medical insurance to a certain patient, or do not cover certain medical expenses, because shortly after contracting the insurance you will detect a disease or pathology that apparently and supposedly existed before entry into the country. strength of the policy.

When there is no pre-existence?

There is no pre-existence when the person, obviously, does not suffer from said disease or pathology prior to contracting health insurance. That is to say, if you currently have a disease that you do not know and that has not caused symptoms or discomfort, not being detected previously.

And if you already have that disease or pathology?

In these cases it must be informed of the existence of said disease in the health questionnaire that all insurers extend to their clients at the time of contracting the insurance. At all times part of the good faith of the client, so today is not necessary to perform a general medical check before the entry into force of the policy (formerly yes it was much more common).

If this disease already exists prior to contracting the insurance, it is the insurance company that finally decides if it covers the medical expenses that it may cause after the policy comes into force. If so, the insurance premium tends to go up, so you'll pay more if you want it to be covered. However, there are also many insurers that do not directly cover it.

This is mainly due to the fact that Medical insurance policies are, in essence, for new diseases and diseases, that appear after your hiring.

Image | Robert Couse-Baker

Pre-Existing Diseases In Health Insurance Explained (April 2024)